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Shingles: Sneaky herpes viruses trigger a treacherous vicious circle

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Shingles: Sneaky herpes viruses trigger a treacherous vicious circle

Shingles causes severe pain. This can lead to depression. These, in turn, can trigger or intensify pain. Can this vicious circle be stopped?

“If I carry pain with me for a long time, I get psychological problems. This can lead to depression, as we see in pain patients. The question keeps coming up: ‘Do I have back pain because I’m depressed? Or am I depressed because I have back pain?’” Günter Rambach knows what he is talking about. The deputy president of the German Pain League himself had shingles, caused by the herpes zoster virus, which is also responsible for chickenpox. Although this childhood illness is unpleasant, it is hardly life-threatening and there are vaccinations against it.

Herpes zoster viruses are sneaky

As a child it is chickenpox, as an adult it is shingles. Almost everyone has had chickenpox at some point. Typical symptoms of the highly contagious viral infection are an itchy rash with red blisters and a mild fever. Children usually survive the disease without serious side effects. Apart from a few scars caused by scratching open the blisters, nothing remains.

But even if the childhood illness has healed, that doesn’t mean that the danger is over. Because the herpes zoster viruses continue to lie dormant in the body and can become active again years or decades later and then trigger the extremely painful shingles. “Without chickenpox, there is no shingles,” says Rambach.

Our body doesn’t forget anything

As you get older, the risk of developing shingles increases. People around the age of 50 with a weakened immune system are particularly at risk. This also includes people over 60, because at this age the immune system no longer works as well as it did when it was younger and it is therefore less able to fight off illnesses.

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A hallmark of shingles is a burning and itching rash, which usually goes away after a few days. Shingles sometimes causes nerve pain. In acute shingles, the inflammatory injuries to the nerve structures are primarily responsible for the pain, because these nerve structures can be damaged by the virus. Post-herpetic neuralgia develops.

The chronic pain can then lead to serious depression. An interaction occurs: the depression makes the pain worse. The pain makes the depression worse. Researchers assume that 66 percent of those who suffer from chronic pain also develop depression.

The immune system plays an important role

Researchers believe that there is no direct medical connection between shingles and depression, but that there are certainly indirect factors. The area has so far been little researched. What is known, however, is that depression and stress make it easy for the virus to become active again.

The reasons for the reactivation of the herpes zoster virus can be both physical and psychological, such as a severe stroke of fate. Rambach tells of a woman whose daughter had breast cancer. “A world collapsed. Her daughter’s illness put such a strain on her that she developed shingles.”

There was a similar case with another woman. She was even vaccinated. “A vaccination does not guarantee that you will never get shingles, but the likelihood is much lower,” adds Rambach. And the infection is much less severe.

When the pain doesn’t stop

When the illness simply refuses to get better, a feeling of hopelessness or despair often takes hold. The pain continues to come to the fore. The rash most commonly appears on the back and chest. It wraps around the body like a ring – or a belt. But it can also affect other places. “The head, eyes, ears and even the genitals can be affected,” says Rambach.

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It can be particularly unpleasant for those affected by so-called postherpetic neuralgia, which manifests itself through, among other things, permanent pain and sensitivity to touch. Antiepileptic drugs are often given and combined with painkillers for treatment. Antidepressants are also used to counteract the melancholy. Some people can also be helped with acupuncture or psychotherapy to finally stop the circulation.

The German Pain League tries to help as much as possible with discussions and advice based on a lot of experience. However, vaccination is still the best way to protect yourself from shingles.

Author: Gudrun Heise

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